In-Hospital Risk Factors for Reintervention and Amputation in Brachial Arterial Trauma

Area of Science:

• Trauma Surgery
• Vascular Surgery
• Injury Management

Background:

• Brachial artery trauma is a rare but severe injury.
• Limited data exists on risk factors for reintervention and amputation prevention.
• Understanding anticoagulant (AC) and antiplatelet (AP) regimens post-discharge is crucial.

Purpose of the Study:

• Identify in-hospital risk factors for reintervention and amputation after brachial artery repair.
• Stratify patient outcomes based on discharge AC or AP regimens.

Main Methods:

• Utilized the AAST Prospective Observational Vascular Injury Trial database (2013-2022).
• Included patients undergoing traumatic brachial arterial repair.
• Evaluated need for reintervention, amputation, and short-term follow-up outcomes based on AC/AP regimens.

Main Results:

• 311 patients required brachial repair; 9% needed reoperation, 2.6% amputation.
• High injury severity score and transfusion of PRBCs/platelets correlated with reoperation/amputation.
• Damage control and shunt use were significant predictors for reoperation.
• 74% of patients received postoperative AC or AP; no significant difference in short-term outcomes by regimen type.

Conclusions:

• Damage control and shunts may increase reoperations but not amputations.
• Intraoperative and postoperative anticoagulation did not significantly reduce reintervention rates.
• No increase in short-term follow-up complications observed with or without AC/AP therapy.